Short-term Nutritional Status Research Articles

Lack of clinical benefit from preoperative short-term parenteral nutrition on the clinical prognosis of patients treated with radical gastrectomy for gastric cancer: a two-center retrospective study based on propensity score matching analysis.

Preoperative nutritional support studies for patients undergoing gastrointestinal (GI) surgery mostly focused on enteral nutrition (EN) or long-term (≥7 days) parenteral nutrition (PN). Some studies also found that preoperative short-term PN could improve the postoperative short-term nutritional status of tumor patients. But whether short-term PN support (1-6 days) before surgery can improve the prognosis of patients undergoing surgery for gastric cancer (GC) remains unclear. Therefore, we focused on assessing the effect of preoperative short-term PN on the outcomes of patients undergoing radical surgery for GC. A retrospective analysis of 1,155 patients who underwent radical gastrectomy for GC between July 2014 and February 2019 was conducted. According to whether patients received short-term (1-6 days) PN support before surgery, patients were divided into non-PN group and PN group. After 1:1 propensity score matching (PSM), two groups of patients with similar baseline clinical characteristics were obtained. The incidence of various complications and overall survival (OS) rate were compared between the two groups, and logistic regression analysis for complications, Cox regression analysis for OS, and subgroup analysis were performed. Each group had 478 patients after PSM, and the clinical characteristics were balanced. There were no significant differences in overall postoperative complications (pre-PSM: P=0.495; post-PSM: P>0.99), postoperative length of stay (LOS; pre-PSM: P=0.092; post-PSM: P=0.460), or readmission rate within 30 days (pre-PSM: P=0.496; post-PSM: P=0.793) between the two groups before and after PSM. The OS of PN group before matching was lower than that of non-PN group (P=0.023), but this difference was not significant after matching (P=0.950), but the PN group's hospitalization expenses were substantially greater than those of the control group (post-PSM: P<0.001). Preoperative short-term PN support was not an independent factor in the incidence of postoperative complications (P>0.99) and OS (P=0.949). Subgroup analyses failed to identify those patients who might benefit from preoperative short-term PN support. Preoperative short-term PN support may have no significant benefit on short-term postoperative complications or the long-term OS of patients with GC but increase hospitalization costs. It thus should not be the first choice of treatment for these patients.

Relationship between preoperative nitrogen balance and energy and protein intake in patients with esophageal cancer.

Nitrogen balance (NB) is an important indicator of protein utilization in the body, and a positive NB is essential for maintaining and improving nutritional status. However, information is lacking on the target values of the energy and protein levels required to maintain positive NB in cancer patients. This study aimed to verify the energy and protein requirements for positive NB in preoperative esophageal cancer patients. This study included patients for esophageal cancer surgery who were admitted for radical surgery. Urine urea nitrogen (UUN) levels were measured based on 24-h urine storage. Energy and protein intakes were calculated from the dietary intake during hospitalization and the amount administered from enteral and parenteral nutrition. The characteristics of the positive and negative NB groups were compared, and patients' characteristics related to UUN excretion were analyzed. Seventy-nine patients with esophageal cancer were included, and 46% of patients were negative NB. All patients with energy intake ≥30 kcal/kg/day and protein intake ≥1.3 g/kg/day had positive NB. Whereas, in the group with energy intake ≥30 kcal/kg/day and protein intake <1.3 g/kg/day, 67% of patients were positive NB. There was a significant positive relation between UUN excretion and retinol-binding protein in multiple regression analyses adjusted for several patients' characteristics (β = 0.28, p = 0.048). In preoperative esophageal cancer patients, 30 kcal/kg/day of energy and 1.3 g/kg/day of protein were the guideline values for positive NB. Good short-term nutritional status was a factor associated with increased UUN excretion.

Nutrients and antioxidants composition of complementary foods produced from brown local rice, soybean, and tiger nut supplemented with orange-fleshed sweet potato

Background: Infants care and feeding practices have a major effect on short term and long term nutritional status of children as most of malnutrition is associated with faltering growth that occur during the period complementary feeding.&#x0D; Objective: This study aimed to evaluate the nutrients and antioxidants composition of complementary food produced from brown local rice, soybean and tiger nut supplemented with orange fleshed sweet potato&#x0D; Materials and methods: Raw materials and other ingredients used for this study were purchased from Ojakoko in Owo Local Government, Ondo State. Four samples were formulated using brown local rice, soyabean, tigernut and orange flesh sweet potato in different ratios (70:60:50:40, 20:20: 20:20, 5:10:15:20, and 5:10:15:20), respectively. The samples were labeled as RSTO1, RSTO2, RSTO3, and RSTO4. A commercial food was used as control (D). Samples were subjected to chemical analysis according to standard methods. The data obtained were statistically analyzed using Statistical Package for Social Science (SPSS version 22). ANOVA was used to test for the significant difference among means at P&lt;0.05.&#x0D; Results: Finding shows that moisture, crude fibre, fat and protein were significantly (p&lt;0.05) higher in sample RSTO3 but, protein content was lower than the value in the control Sample RSTO1 had the highest carbohydrate and ash content among the samples. Vitamin B3, B6 and B9 are significantly (p&lt;0.05) higher in Sample RSTO4, RSTO3, andRSTO1. All the samples have appreciable amount of beta-carotene, flavonoid, total phenol, sodium, calcium and potassium. Sample RSTO3 was exceptionally high in minerals but significantly (p&lt;0.05) lower than that of the control except for copper and magnesium. &#x0D; Conclusion: The formulated complementary foods had improved nutrients and antioxidants which can support optimal growth of undernourished children and other age-groups.

Motivational regulations and lifestyle in muscle-wasted COPD patients undergoing pulmonary rehabilitation

<h2>Summary</h2><h3>Background & Aims</h3> Low physical activity (PA) levels and a poor-quality diet are common in chronic obstructive pulmonary disease (COPD) patients eligible for pulmonary rehabilitation (PR). PR may improve short-term nutritional status and exercise capacity but generally not long-term lifestyle outcomes. We hypothesized that healthy lifestyle motivation is related to PA levels and dietary quality before PR and the responsiveness thereof after PR. <h3>Methods</h3> Before and after standardized outpatient PR, 81 COPD patients with low muscle mass completed validated motivational regulation self-reports. Physical (in)activity was assessed before and after PR through 7-day accelerometry (GT3X Actigraph). Dietary quality was assessed using a validated cross-check dietary history before and after PR and quantified as the Mean Adequacy Ratio (MAR). <h3>Results</h3> Patients' baseline motivational profile was unrelated to dietary quality or PA. Baseline integrated motivation and its change during PR significantly predicted MAR change during PR and its levels after PR. Baseline introjected motivation and its change during PR significantly predicted PA change during PR and its levels after PR. <h3>Conclusions</h3> Specific motivational regulations predict dietary quality and PA improvements of patients with COPD admitted to PR. Therefore, targeting integrated and introjected motivation may be key to achieving lasting behavior change after PR. <h3>Registry site</h3> Maastricht University Medical Centre+. <h3>Clinical trial identifier number</h3> NCT01344135.

Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes

ObjectiveTo evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma.MethodsThe clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups.ResultsThere was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05).ConclusionsEarly oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.

Isoperistaltic versus antiperistaltic uncut Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: a propensity score matched analysis

BackgroundThe uncut Roux-en-y anastomosis (URYA) has some clinical advantages after distal gastrectomy (DG). Little evidence exists regarding the influence of peristalsis on this anastomosis. We aimed to evaluate short-term outcomes of isoperistaltic URYA (iso-URYA) comparing with antiperistaltic URYA (anti-URYA) after DG.MethodPatients who underwent URYA for gastric cancer (GC) between January 2016 and December 2018 were selected from Shanghai Changhai Hospital, Navy Medical University. Short-term outcomes were compared between iso-URYA group and anti-URYA group after 1:1 propensity score matching (PSM).ResultA total of 612 patients were selected. 392 patients underwent iso-URYA and 220 patients underwent anti-URYA. After PSM, 183 patients for each group were included in the final analysis. No differences were found between them in terms of short-term complications, nutritional status and quality of life 1 year after surgery. Endoscopic examination showed that anti-URYA group had more severe gastritis (P = 0.036). In addition, the recanalization rate was significantly higher when the afferent loop was blocked by stapler.ConclusionThe iso-URYA and anti-URYA group present similar results in short term outcomes. Ligation blocking afferent loop leads to lower recanalization rate.

Comparisons of Postoperative Complications and Nutritional Status After Proximal Laparoscopic Gastrectomy with Esophagogastrostomy and Double-Tract Reconstruction.

The purpose of this study was to compare postoperative complications and nutritional status between esophagogastrostomy and double-tract reconstruction in patients who underwent laparoscopic proximal gastrectomy, and assess the advantages of both surgical procedures. Between 2010 and 2018, 47 cases underwent proximal gastrectomy with esophagogastrostomy (n = 23) or double-tract reconstruction (n = 24) at our institution for the treatment of clinical T1N0 adenocarcinoma located in the upper third of the stomach. Patient clinical characteristics, short-term outcomes, nutrition status, and skeletal muscle index were compared among the two groups. There was no significant difference between esophagogastrostomy and double-tract reconstruction in terms of operation time, blood loss, and length of postoperative hospital stay. Reflux symptoms and anastomotic stenosis were significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group (P < 0.001 and P = 0.004, respectively). There was no significant difference in anastomotic leakage, surgical site infection, and pancreatic fistula. For the nutritional status, the decrease rate of cholinesterase was significantly higher in the esophagogastrostomy group compared with the double-tract reconstruction group at 6 months (P = 0.008) There was no significant difference in the decrease rate of skeletal muscle mass index at 1 year after surgery. Compared with esophagogastrostomy, double-tract reconstruction tends to have better short-term nutritional status and postoperative outcomes in terms of preventing the occurrence of gastroesophageal reflux and anastomosis stenosis. These findings suggest that double-tract reconstruction may be a useful method in laparoscopic proximal gastrectomy.

Life on the Rainforest Edge: Food Security in the Agricultural-Forest Frontier of Cross River State, Nigeria

A growing body of evidence demonstrates the importance of forests and wild animal-based foods for diets within tropical environments. However, deforestation and associated land-use changes can have competing effects on nutrition and food security as communities reorient from wild food use and subsistence-based agriculture to import/export markets. This research examines dietary differences and associated changes in food security during intermediate stages of deforestation and market integration in the agriculture-forest frontier of Cross River State, Nigeria. We used participant responses to mixed-methods interviews (n=528) in six communities to measure individual dietary diversity, household food access, and short-term nutritional status, with specific attention to animal-based foods and the cultural and economic values attached to them, in two interior forest (n=177) and four forest-edge (n=351) communities. Multivariate analysis of dietary compositions revealed differences in food categories and types of meat consumed between forest environments. People in forest-edge communities reported consuming less bushmeat and dark green leafy vegetables, and more pulses, domestic meat, fish, eggs, dairy, other vegetables, sweets, condiments, and non-red palm oil compared to interior forest communities. Bushmeat was highly preferred and had more economic value than other animal-based foods, regardless of location. Forest-edge communities had fewer households involved in bushmeat related activities, and fewer hunters per household. However, traders in forest-edge communities sold a larger proportion of meat to people outside of the community than did traders in interior forest communities. Measures of nutrition and food security, but not wealth, improved in relation to dietary patterns in forest-edge communities compared to interior forest communities. Our results may reflect a “best of both worlds” scenario during the intermediate stages of deforestation and agricultural expansion near forested areas, where people have access to forest resources, increased ability to capitalize on forest goods, and access to market goods as they become integrated into market economies. Understanding the dietary consequences of environmental change is important, as food-related experiences may shape the trajectories of livelihood practices and landscape changes in tropical forests of biodiversity significance.

Effects of oral nutritional supplement on short-term nutritional status and treatment tolerance in locally advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy

Objective To explore the impact of oral nutritional supplements in the local advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy. Methods From 2016 to 2018, we prospectively collected 114 patients into our study, including intervention group (n=58) and control group (n=56). Patients in the intervention group were given oral nutritional supplements from the beginning of radiotherapy, while the control group patients were receiving usual diet care. We collected data of weight, hematological index and nutrition related information before, during and after treatments. Results All patients experienced weight loss during radiotherapy. The declining trend was more obvious in intervention group but with no statistical difference (P>0.05). Radiotherapy interruption was lower, completion rate of 2 cycles of concurrent chemotherapy was higher(78% vs 64%, P=0.02)and level of total serum protein and albumin was more stable (P=0.003, 0.001) in the intervention group. No difference was found in acute toxicities between the two groups (P>0.05). During the treatment period, the nutrition risk screening score declined, more patients with NRS 2002 ≥3 in the control group than the intervention group (P 0.05). Conclusions Oral nutritional supplements can improve treatment tolerance and keep the stability of serum protein level, nevertheless, it has no obvious advantage in maintenance of weight and short-term nutritional status Key words: Nasopharyngeal neoplasms/chemoradiotherapy; Nutrition supplement; Treatment tolerance

Postoperative nutritional benefits of proximal parenchymal pancreatectomy for low-grade malignant lesions in the pancreatic head

BackgroundOutcomes of proximal parenchymal pancreatectomy (PPP) as compared to pancreatoduodenectomy (PD) have not been reported. The aim of this study was to describe the short- and long-term outcomes of patients with low-grade pancreatic head lesions who underwent PPP or PD. MethodsPatients who underwent PPP or PD for low-grade lesions between 2009 and 2017 were included. Operative factors including postoperative complications and nutritional indicators during the first-year postoperatively were compared. ResultsA total of 13 and 14 patients underwent PPP and PD respectively. The PPP group demonstrated significantly less intraoperative blood loss and shorter postoperative hospital stay than the PD group. No significant differences were noted in the incidence of postoperative complications between the two groups. Nutritional indices were significantly better in the PPP group at 3 months post-surgery, but these nutritional indices were not significantly different at 6 months and 1-year. None of 12 patients who underwent PPP and did not require biliary resection developed postoperative cholangitis. None of the 12 PPP patients without preoperative diabetes developed impaired glucose tolerance after surgery. DiscussionThe complication rate of PPP is equivalent to that of PD. PPP demonstrated better short-term nutritional status than PD. Moreover, preservation of the total duodenum and bile duct may reduce the risk of developing postoperative diabetes and cholangitis.

The effect of young children's faeces disposal practices on child growth: evidence from 34 countries.

To characterize the relationship between child faeces disposal and child growth in low- and middle-income countries. We analysed caregiver responses and anthropometric data from Demographic and Health Surveys (2005-2014) for 202614 children under five and 82949 children under two to examine the association between child faeces disposal and child growth. Child faeces disposal in an improved toilet was associated with reduced stunting for children under five [adjusted prevalence ratio (aPR)=0.90, 95% confidence interval (CI) 0.89-0.92] and a 0.12 increase in height-for-age z-score (HAZ; 95% CI: 0.10-0.15) among all households. Among households with improved sanitation access, practicing improved child faeces disposal was still associated with a decrease in stunting (aPR=0.94, 95% CI: 0.91-0.96) and a 0.09 increase in HAZ (95% CI: 0.06-0.13). Improved child faeces disposal was also associated with reductions in underweight and wasting, and an increase in weight-for-age z-score (WAZ), but not an increase in weight-for-height z-score (WHZ). Community coverage level of improved child faeces disposal was also associated with stunting, with 75-100% coverage associated with the greatest reduction in stunting. Child faeces disposal in an unimproved toilet was associated with reductions in underweight and wasting, but not stunting. Improved child faeces disposal practices could achieve greater reductions in child undernutrition than improving toilet access alone. Additionally, the common classification of child faeces disposal as 'safe' regardless of the type of toilet used for disposal may underestimate the benefits of disposal in an improved toilet and overestimate the benefits of disposal in an unimproved toilet.

Determinants of severity levels of anemia among children aged 6–59 months in Ethiopia: further analysis of the 2011 Ethiopian demographic and health survey

Childhood anemia is the major public health problem in Ethiopia. It has been implicated with growth retardation, impaired motor and cognitive development, and childhood morbidity and mortality. Thus this study aimed to identify determinants of severity levels of anemia in children aged 6 to 59 months in Ethiopia. The study was further analysis of the 2011 Ethiopian Demographic and Health Survey. A total of 7636 children aged 6 to 59 months with complete information on the selected predictors were included in the analysis. Proportional odds model of ordinal logistic regression was used to identify determinant factors. Chi-square test of parallelism was used to evaluate the appropriateness of proportional odds assumption. A p-value less than 0.05 was considered as statistically significant. The Chi-square test of parallelism showed that the odds ratios were constant across all cut-off points of childhood anemia status at 5 % level (p-value = 0.071). Of the total children sampled, 28.6 and 21.7 % of them were severely/moderately and mildly anemic, respectively. Wasting, Stunting, religion, and age of the child, current employment status of the mother, educational status of the partner, number of under-5 children in the household, source of drinking water and mother’s anemia status were found to be statistically significant determinants of severity levels of childhood anemia. The likelihoods of being severely/moderately anemic as compared to being mildly/non-anemic, and being severely/moderately/mildly anemic as compared to being non-anemic were similar for a given variable keeping all others. Long term and short term nutritional status of young aged children, access to health and nutritional education, and access to safe drinking water should be improved by the concerned body.

Seasonal effect and long-term nutritional status following exit from a Community-Based Management of Severe Acute Malnutrition program in Bihar, India.

Background/Objectives:Children aged 6 months to 5 years completing treatment for severe acute malnutrition (SAM) in a Médecins Sans Frontières Community Management of Acute Malnutrition (CMAM) program in Bihar, India, showed high cure rates; however, the program suffered default rates of 38%. This report describes the nutritional status of 1956 children followed up between 3 and 18 months after exiting the program.Subjects/Methods:All children aged 6–59 months discharged as cured with mid-upper arm circumference (MUAC) ⩾120 mm or who defaulted from the program with MUAC <115 mm were traced at 3, 6, 9, 12 and 18 months (±10 days) before three exit reference dates: first at the end of the food insecure period, second after the 2-month food security and third after the 4-month food security.Results:Overall, 68.7% (n=692) of defaulters and 76.2% (n=1264) of children discharged as cured were traced. Combined rates of non-recovery in children who defaulted with MUAC <115 mm were 41%, 30.1%, 9.9%, 6.1% and 3.6% at 3, 6, 9, 12 and 18 months following exit, respectively. Combined rates of relapse among cured cases (MUAC ⩾120 mm) were 9.1%, 2.9%, 2.1%, 2.8% and 0% at 3, 6, 9, 12 and 18 months following discharge, respectively. Prevalence of undernutrition increased substantially for both groups traced during low food security periods. Odds of death were much higher for children defaulting with MUAC <110 mm when compared with children discharged as cured, who shared the same mortality risk as those defaulting with MUAC 110–<115 mm.Conclusions:Seasonal food security predicted short-term nutritional status after exit, with relapse rates and non-recovery from SAM much higher during food insecurity. Mortality outcomes suggest that a MUAC of 110 mm may be considered an appropriate admission point for SAM treatment programs in this context.

The effects of market integration on childhood growth and nutritional status: The dual burden of under‐ and over‐nutrition in the Northern Ecuadorian Amazon

Market integration is an important source of cultural change exposing indigenous populations to epidemiologic and nutrition transitions. As children and adolescents are biologically sensitive to the health effects of market integration, we examine community variation of anthropometric indicators of nutritional status and growth among a cross-cultural sample of Kichwa, Shuar, Huaorani, and Cofán indigenous groups in the northern Ecuadorian Amazon. We measured height, weight, body mass index (BMI), upper arm circumference, and triceps skinfolds of 186 children and adolescents aged 2 to 18 years from seven communities. Anthropometric z-scores were calculated based on the National Health and Nutritional Examination Survey. Comparisons were made with this US reference group, along with between community differences to contextually explore the impacts of varying degrees of market integration. We found a high prevalence of stunting in both boys (40%) and girls (34%). Adiposity increased with age and 40% of girls between 15 and 18 years old were overweight. There were large sex differences in body composition with higher BMI, arm circumference, and triceps skinfolds in adolescent girls. The Kichwa demonstrated the poorest growth outcomes and nutritional stress followed by the Huaorani and Shuar; yet distinctions in under- and over-nutrition were evident within groups. Market integration is a major factor influencing the developmental and lifestyle mismatch associated with the epidemiologic and nutrition transition in general, and the dual burden pattern of high rates of stunting yet adequate to above average short-term nutritional status indicators found among indigenous Amazonian populations.

Post-Cyclone Sidr nutritional status of women and children in coastal Bangladesh: an empirical study

Cyclone Sidr, a Category 4 storm, struck the southwestern coast of Bangladesh on November 15, 2007, causing 3,406 deaths, 2.51 million acres of crop damage, and aggregated damage of US$1.7 billion. It significantly damaged household food availability and increased post-cyclone nutritional insecurity. This study assesses the nutritional status of household and explores influences of various socioeconomic variables on nutritional security. More specifically, it explores the impact of the cyclone on short-term nutritional status of women of reproductive age and children under 5 years. For this study, 331 households living in three villages devastated by Cyclone Sidr were selected. The nutritional status of women of reproductive age was measured based on body mass index, and that of children aged 6–59 months was measured based on weight-for-height (wasting), height-for-age (stunting), and weight-for-age (underweight). This study found that the nutritional status, along with other household characteristics, of the study groups was not remarkably different across the three selected villages. Findings of this study further suggest that the nutritional security situation was not much changed in the post-cyclone period compared with the pre-cyclone period primarily because of rapid and effective distribution of essential food items among cyclone survivors by the government of Bangladesh along with donor and other organizations. However, nutritional insecurity was more prevalent in the island village relative to inland and coastline villages. Similarly, fishermen were found to be the most vulnerable to nutritional insecurity in the post-cyclone period. Several recommendations are made to improve food aid distribution in the aftermath of a cyclone.

DEFICIENCIA DE SELENIO EN UNA POBLACIÓN ADULTA SANA ESPAÑOLA

Introduction: Selenium is an essential micronutrient for human health, being a cofactor for enzymes with antioxidant activity that protect the organism from oxidative damage. An inadequate intake of this mineral has been associated with the onset and progression of chronic diseases such as hypertension, diabetes, coronary diseases, asthma, and cancer. For this reason, knowledge of the plasma and erythrocyte selenium levels of a population makes a relevant contribution to assessment of its nutritional status. Objetive: The objective of the present study was to determine the nutritional status of selenium and risk of seleniumdeficiency in a healthy adult population in Spain by examining food and nutrient intake and analyzing biochemical parameters related to selenium metabolism, including plasma and erythrocyte levels and selenium-dependent glutathione peroxidase (GPx) enzymatic activity. Material and methods: We studied 84 healthy adults (31 males and 53 females) from the province of Granada, determining their plasma and erythrocyte selenium concentrations and the association of these levels with the enzymatic activity of glutathione peroxidase (GPx) and with life style factors. We also gathered data on their food and nutrient intake and the results of biochemical analyses. Correlations were studied among all of these variables. Results: The mean plasma selenium concentration was 76.6 ± 17.3 μg/L (87.3 ± 17.4 μg/L in males, 67.3 ± 10.7 μg/L in females), whereas the mean erythrocyte selenium concentration was 104.6 μg/L (107.9 ± 26.1 μg/L in males and 101.7 ± 21.7 μg/L in females). The nutritional status of selenium was defined by the plasma concentration required to reach maximum GPx activity, establishing 90 μg/L as reference value. According to this criterion, 50% of the men and 53% of the women were selenium deficient. Conclusions: Selenium is subjected to multiple regulation mechanisms. Erythrocyte selenium is a good marker of longerterm selenium status, while plasma selenium appears to be a marker of short-term nutritional status. The present findings indicate a positive correlation between plasma selenium concentration and the practice of physical activity. Bioavailability studies are required to establish appropriate reference levels of this mineral for the Spanish population.

Deficient selenium status of a healthy adult Spanish population.

Selenium is an essential micronutrient for human health, being a cofactor for enzymes with antioxidant activity that protect the organism from oxidative damage. An inadequate intake of this mineral has been associated with the onset and progression of chronic diseases such as hypertension, diabetes, coronary diseases, asthma, and cancer. For this reason, knowledge of the plasma and erythrocyte selenium levels of a population makes a relevant contribution to assessment of its nutritional status. The objective of the present study was to determine the nutritional status of selenium and risk of selenium deficiency in a healthy adult population in Spain by examining food and nutrient intake and analyzing biochemical parameters related to selenium metabolism, including plasma and erythrocyte levels and selenium-dependent glutathione peroxidase (GPx) enzymatic activity. We studied 84 healthy adults (31 males and 53 females) from the province of Granada, determining their plasma and erythrocyte selenium concentrations and the association of these levels with the enzymatic activity of glutathione peroxidase (GPx) and with life style factors. We also gathered data on their food and nutrient intake and the results of biochemical analyses. Correlations were studied among all of these variables. The mean plasma selenium concentration was 76.6 ± 17.3 μg/L (87.3 ± 17.4 μg/L in males, 67.3 ± 10.7 μg/L in females), whereas the mean erythrocyte selenium concentration was 104.6 μg/L (107.9 ± 26.1 μg/L in males and 101.7 ± 21.7 μg/L in females). The nutritional status of selenium was defined by the plasma concentration required to reach maximum GPx activity, establishing 90 μg/L as reference value. According to this criterion, 50% of the men and 53% of the women were selenium deficient. Selenium is subjected to multiple regulation mechanisms. Erythrocyte selenium is a good marker of longer term selenium status, while plasma selenium appears to be a marker of short-term nutritional status. The present findings indicate a positive correlation between plasma selenium concentration and the practice of physical activity. Bioavailability studies are required to establish appropriate reference levels of this mineral for the Spanish population.

CCK stimulation of GLP-1 neurons involves α1-adrenoceptor-mediated increase in glutamatergic synaptic inputs.

OBJECTIVEGlucagon-like peptide 1 (GLP-1) is involved in the central regulation of food intake. It is produced within the brain by preproglucagon (PPG) neurons, which are located primarily within the brain stem. These neurons project widely throughout the brain, including to the appetite centers in the hypothalamus, and are believed to convey signals related to satiety. Previous work demonstrated that they are directly activated by leptin and electrical activity of the afferent vagus. Another satiety hormone, cholecystokinin (CCK), has also been linked to activation of brain stem neurons, suggesting that it might act partially via centrally projecting neurons from the nucleus tractus solitarius (NTS). The aim of this study was to investigate the neuronal circuitry linking CCK to the population of NTS-PPG neurons.RESEARCH DESIGN AND METHODSTransgenic mice expressing yellow fluorescent protein (Venus) under the control of the PPG promoter were used to identify PPG neurons in vitro and to record their electrical and pharmacological profile.RESULTSPPG neurons in the NTS were excited by CCK and epinephrine, but not by the melanocortin receptor agonist melanotan II. Both CCK and epinephrine acted to increase glutamatergic transmission to the PPG neurons, and this involved activation of α1-adrenergic receptors. Inhibition of adrenergic signaling abolished the excitatory action of CCK.CONCLUSIONSCCK activates NTS-PPG cells by a circuit involving adrenergic and glutamatergic neurons. NTS-PPG neurons integrate a variety of peripheral signals that indicate both long-term energy balance and short-term nutritional and digestional status to produce an output signal to feeding and autonomic circuits.

Modifying effect of maternal nutritional status on the impact of maternal multiple micronutrient supplementation on birthweight in Indonesia

Low birthweight (LBW) and intrauterine growth restriction are linked with maternal nutritional status during pregnancy, and maternal supplementation with multiple micronutrients (MMNs) is reported to increase birthweight. Responses to MMN, however, might be modified by maternal nutrition. To examine the differential effects of maternal nutritional status on birthweight responses to prenatal MMN supplementation, data from the Supplementation with Multiple Micronutrient Intervention Trial, a cluster-randomized trial in Indonesia was analyzed. Birthweight outcomes of 7001 infants whose mothers received iron/folic acid were compared with 7292 infants whose mothers received MMN. The modifying effects of maternal short-term nutritional status (mid-upper arm circumference (MUAC) and long-term nutritional status (height) on the birthweight response to MMN supplementation were assessed. For women with higher MUAC (≥23.5 cm), MMN increased mean birthweight by 33 g (95% confidence interval (CI): -1 to 66, P=0.06) and significantly reduced LBW by 21% (relative risk: 0.79, 95% CI: 0.64-0.99, P=0.04). The modifying effect of MUAC on mean birthweight, LBW and small for gestational age was significant. There was no evidence of a modifying effect of maternal height on the response to MMN. Supplementation with MMN in pregnancy increased birthweight, but maternal nutritional status modified this response, with infants born to women with better short-term nutrition having greater birthweight response.

AIDS treatment and intrahousehold resource allocation: Children's nutrition and schooling in Kenya

The provision of antiretroviral medications is a central component of the response to HIV/AIDS and consumes substantial public resources from around the world, but little is known about this intervention's impact on the welfare of children in treated persons' households. Using longitudinal survey data from Kenya, we examine the relationship between the provision of treatment to adults and the schooling and nutrition outcomes of children in their households. Weekly hours of school attendance increase by over 20% within 6 months after treatment is initiated for the adult patient. We find some weak evidence that young children's short-term nutritional status also improves. These results suggest how intrahousehold allocations of time and resources may be altered in response to health improvements of adults.